How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,096 to $17,783Professionalmedian $1,122 · 10th to 90th $110 to $1,778
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,288.25 Median $10,964.78 Typical High $21,877.62 | Facility | None | $1,288.25 | $10,964.78 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,148.15 | $1,288.25 | $1,288.25 |
BCBS South Carolina Setting Facility Modifier None Typical Low $1,202.26 Median $5,495.41 Typical High $17,378.01 | Facility | None | $1,202.26 | $5,495.41 | $17,378.01 |
BCBS South Carolina Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $2,089.30 | Professional | None | $977.24 | $1,348.96 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,235.94 Typical High $4,677.35 | Facility | None | $630.96 | $3,235.94 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $2,398.83 | Professional | None | $1,230.27 | $1,318.26 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $1,348.96 Typical High $3,162.28 | Facility | None | $912.01 | $1,348.96 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,318.26 | $1,445.44 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $977.24 Typical High $1,698.24 | Professional | None | $97.72 | $977.24 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $4,265.80 Typical High $24,547.09 | Facility | None | $1,445.44 | $4,265.80 | $24,547.09 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $2,344.23 | Professional | None | $1,096.48 | $1,412.54 | $2,344.23 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $575.44 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $229.09 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $851.14 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $169.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $114.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $794.33 | $891.25 | $891.25 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $2,187.76 Typical High $3,162.28 | Professional | 50 · Both sides | $2,137.96 | $2,187.76 | $3,162.28 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $707.95 Median $724.44 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $707.95 | $724.44 | $1,047.13 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $288.40 Typical High $416.87 | Professional | 80 · Assistant surgeon | $281.84 | $288.40 | $416.87 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $199.53 Median $204.17 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $199.53 | $204.17 | $288.40 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $199.53 Median $204.17 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $199.53 | $204.17 | $288.40 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $204.17 Typical High $288.40 | Professional | AS · PA/NP assist | $199.53 | $204.17 | $288.40 |
Where South Carolina sits
The same service costs 6.8 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
South Carolina· 44th of 51
$1,230
AK $4,677TX $692
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.